Anticipated nursing care: findings from a qualitative study

Abstract

Background Contrary to Missed Nursing Care, some anecdotal data and sparse evidence has documented the tendency of nurses to anticipate some nursing interventions. However, no study has been conducted to date with the purpose of understanding this phenomenon and its underlying mechanisms and consequences. The aim of this study was to describe the phenomenon of delivering anticipated nursing care, its antecedents and consequences as perceived by nurses. Method A descriptive qualitative study. The Consolidated Criteria for Reporting Qualitative Research guidelines were followed. A purposeful sample of 17 clinical nurses and nurse managers working in three Italian hospitals were interviewed in depth in 2019. The audio-recorded interviews were verbatim transcribed and thematically analysed. Results ‘Anticipated Nursing Care’ is delivered significantly earlier than when expected by nurses in their care plan, by patients, by caregivers and by other members of the team. Medication administration, mobilisation of patients, hygiene care, changes of dressing, vital parameter monitoring, blood sampling and administrative activities were reported as interventions delivered before rather than when expected. Clinically stable patients have been reported to be at risk of receiving anticipated nursing care. Individual values and attitudes, group attitudes of being always ready for the “unexpected”, implicit group norms to “leave the patients and the unit in order”, high workloads, intertwined activities and work processes inside the units, have been reported as reasons for Anticipated Nursing Care. Effects of this phenomenon have been reported at the patients’ and at the nurses’ level. Conclusion Anticipated Nursing Care occurs when nurses perform interventions earlier than expected according to an implicit or explicit decision and not as a consequence of a request. The phenomenon requires future studies to detect its diffusion and to accumulate evidence. Its presence in daily practice, if confirmed, suggests that Missed Nursing Care studies should also consider the combined effect of these two phenomena as, on one hand, there may be the tendency to postpone and, on the other hand, the tendency to anticipate interventions.

Predictors of events of violence or aggression against nurses in the workplace: A scoping review

“…In many studies included in this review, victims' personal characteristics such as gender, age, work experience and educational level, are reported to be risk factors for violence perpetrated by patients or family members. Limited professional experience not underpinned by appropriate communication skills, combined with inability to anticipate patient needs (Bottega & Palese, 2020 ), do not enable to notice the initial signs of aggression and consequently prevent it. Other studies have shown that specific interventions aimed at raising nurses' awareness about risk factors, such as young age and limited experience, are essential in reducing aggressive behaviors in patients and their families (Hill et al, 2015 ; Shi et al, 2017 ).…”

Ubiety in nursing practice: Making each patient the star of the minute

“…Anticipated nursing care has been used to prevent missed or delayed care and for time management. [29][30][31] Exemplar nurses utilize anticipation of both nursing care and patient needs to avoid distractions and provide PCC. Anticipation also requires teamwork and proper delegation of tasks.…”

Anticipated nursing care as perceived by nursing students: Findings from a qualitative study

“…To the best of our knowledge, this is the first study that attempts to describe ANC, together with its antecedents and consequences, as experienced by students during their clinical rotations. Prior to recent studies (Bottega & Palese, 2020), ANC was reported mainly through anecdotal evidence as an expression of routines, traditions and rituals of nursing practice, and a potential issue of the theory–practice gap (Bourgault & Upvall, 2019; Rytterstrom et al., 2011; Shoghi et al., 2019), mostly from the perspective of nurses. However, the clinical environment permeates nursing education, enabling students to develop skills (Papastavrou et al., 2016).…”

“…Data were collected using face‐to‐face, audio‐recorded interviews performed from July to September 2019. The interview guide was developed according to the open‐ended questions reported in Table 2 and the evidence available on ANC (Bottega & Palese, 2020). A preliminary piloting of the interview guide with one interview was conducted by two researchers (refer authors), and it was subsequently confirmed that no changes were requested.…”

“…Alongside MNC, students are also exposed to anticipated nursing care (ANC), which has been defined as care required by patients that is delivered early (in part or in whole) compared to when it is expected by patients and specified by the nursing care plan (Bottega & Palese, 2020). ANC is completely the opposite of MNC: it refers to any intervention delivered in an anticipated manner on a regular basis rather than occasional or in critical circumstances.…”